| NPI | 1922628122 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TN 73787) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 036170437) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-04-17 |
| Last Update Date | 2025-09-09 |